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Is D2 Lymphadenectomy Essential for Cytology-positive Gastric Cancer? A Retrospective Analysis
Shunji Endo1, Kazuhiro Nishikawa2, Kazumasa Fujitani3
1Department of Surgery, Yao Municipal Hospital, Osaka, Japan shunji.endo@hosp-yao.osaka.jp.
Background:
The appropriate extent of lymphadenectomy on gastric cancer patients with positive peritoneal cytology (CY1) is uncertain. This study retrospectively compared overall survival (OS) after standard and limited lymphadenectomy.
Patients And Methods:
The medical records from four institutions from 2004 to 2018 were reviewed and data for 91 patients with CY1, but no other distant metastases, who underwent gastrectomy were analyzed. D2 or greater lymphadenectomy and less than D2 lymphadenectomy were performed in 51 and 40 patients, respectively.
Results:
Full cohort analyses showed that patients who underwent D2 or greater lymphadenectomy had better prognostic nutritional indices and more such patients received postoperative chemotherapy. The OS in the group treated with D2 or greater lymphadenectomy was also significantly better (p=0.045). Twenty-seven pairs of patients were generated via propensity score matching, and analysis of their OS showed no significant difference between the groups according to lymphadenectomy (p=0.61).
Conclusion:
The extent of lymphadenectomy may not affect the prognoses for patients with CY1 gastric cancer.
